Updated: Feb 4
How you can make a home that supports any stage of life
According to the Population Reference Bureau "The number of Americans ages 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060, and the 65-and-older age group’s share of the total population will rise from 16 percent to 23 percent." The AARP has indicated that 90% of retiree's want to age in their homes. Great! So what's the issue with my house? Homes are not required to be accessible. Never have been. As a matter of fact the traditional home is built to be more of a burden than helping someone with cognitive or mobility issues and their caregivers.
The Americans With Disabilities Act which was enacted in 1990 only applies to public places and multi-family homes that contain four or more units. According to the Centers for Disease Control 26% of Americans have at least one type of disability. That's one in four people. Creating environments that not only accommodate the needs of an aging person now, their in-home caregivers, and their needs twenty years from now, and doing it in existing spaces that weren't made to support these changes can be challenging, but it is doable. What are some things we can do to accommodate for aging in our homes that can support independence and be safe? Below are a small sampling of things to consider. If you would like a more thorough evaluation please contact Design Works Studio for an appointment to discuss options with a Certified Aging in Place Specialist.
First let's look at some of the challenges that may come as we age. The number one injury in the home and at facilities are falls. While these can come from some sort of hazard on the ground this is not the only cause. Senior living facilities have found an increase in hip fractures that the resident didn't know they had from simply 'plopping' (falling a short distance) into chairs that were too low. Second, as we age our eyesight can become challenging. As we age our eyes yellow making seeing contrasting colors more difficult and limiting depth perception. Plus the average person in his/her 60's needs three times the light of a younger person to see the same surface. Coordination can also diminish as we get older. Add to that decreases in bone density and muscle tissue atrophy an injury could be immanent. This doesn't include any existing health conditions or medications that can cause dizziness or lightheadedness, disorientation, hallucinations, and heart palpitations to name a few. Then you have assistive equipment such as walkers or wheelchairs in environments that weren't made to accommodate them. So how do we deal with all of this in our homes? Here is a short list of things to look out for when creating a safe environment.
Exterior of the home:
Let's take a brief look at how we enter our homes to see where we can make changes.
Entering the home: Observe the common paths from the car to the front door or the path to and from the mailbox, if it's at the end of the property. Are their stairs that could be an issue? Are their obstructions, cracks, raised areas on the ground that could be a tripping hazard? Do these surfaces get slippery when the weather changes?
Handrails: If you have steps in the garage or to the porch or front door, or a steep sloped walkway, consider installing railing and handrail. Also consider the distance to get into the house. How many feet can your loved one walk without the need to hold on to something or sit?
Yard Maintenance: Doing things like mowing the lawn, trimming bushes, cleaning gutters, planting flowers, watering plants, and even sloping yards can become difficult to navigate. Hiring someone to come in would be the most prudent, but also making sure that the yard is safe to navigate for walks outside should be considered. Are there tripping hazards like protruding rocks, tree roots, or steep inclines to navigate around? Consider a raised garden bed for flowers and vegetables so there is no bending or crouching. Benches thoughtfully places around the yard encourages outside time, which studies have shown to help with mood and healing. Changing out plants for ones that are drought tolerant and don't require a lot of work can help with yard maintenance. Installing a drip watering system on a timer can remove the need for someone to water plants.
Lighting: Having a well lit exterior can help with navigation and prevent injury or falls. Outdoor lighting by the front door is usually present, but is it bright enough? Does it turn on automatically through motion when someone approaches? Can the homeowner see the lock and door knob or any steps at the front door? Installing solar or low voltage wired lighting next to pathways and driveways can help guide a person as well as prevent falls.
Front Door: Most front doors have a raised threshold and a doormat that can create a tripping hazard. Door width can also be an issue if the occupant is using a walker or wheelchair. Changing the door knob to a lever can assist someone with arthritis and it's easier to open if your hands are full of groceries. A storm door with a closer can create an issue as it won't stay open and will close against the occupant. Simply removing it is an easy solution. Finally, a covered entrance by use of an awning or porch can provide protection during storms.
Let's take a look at some basics for the interior that I'm sure you'll notice similarities with the outside environment.
Lighting: Even if you have an existing home, technological advances have made this a very easy thing to improve on in any home. As I stated earlier, the older we get the more lighting intensity needs to be increased. Between three and five times stronger. However, there are other things to consider than upping the lumen output of a bulb (Lumens used to be called 'wattage' on light bulb packages this term is incorrect. Lumen output is the actual light output of a bulb whereas wattage is the energy output). LED lights are outnumbering incandescent light bulbs in any housewares store these days and this technology has several advantages. First, they last a lot longer so changing bulbs isn't an issue as much. They save money; always a good thing. They come in a dimmable option now so changing from a brighter lumen output during the day to a night-light function is possible. And my favorite part, although this may require assistance by a relative to set up, is their ability to connect to voice activated technology (Amazon Echo or Google Home). No longer do we have to push a switch on a lamp or pull a chain. Plus with the app's smart home functions common routines can be made automatic. Does your mom always wake up at 6 AM? You can set her lights to turn on at that time from the bedroom all the way to the kitchen.
Night Lights: A majority of falls happen at night due to disorientation, dizziness or lightheadedness upon standing, and just not being able to see where we are going. Installing battery powered, motion activated night lights from the bed to the bathroom and to the kitchen doesn't cost a lot and is easy to install with 3m strips.
Flooring surfaces: Walk through the house and take notice of what is on the floor and the materials. Are there area rugs that could pose a tripping hazard? Changes to flooring heights between rooms or transition strips? Is there a flooring finish that is very smooth and could be slippery dry or wet? Are there electrical or extension cords that could be tripped over? Removing rugs is a simple solution. Changing flooring is more complicated and can get expensive, but the average cost of a fall (hospital stay, rehab in a facility, etc.) is more than $14,000.00. Changing out a flooring material could be a quarter of that, depending on size and material cost. An interior designer who is also a Certified Aging-in-Place Specialist can help coordinate new flooring selections to go with your existing finishes and furnishings. We can also refer contractors who are also Certified Aging-in-Place specialists.
Circulation: What do I mean by circulation? What is the path you take from the sofa to the kitchen. From the kitchen to the bathroom. Bathroom to bedroom and so on. The goal is having the room to move safely around the house by wheelchair or walker without running into lots of obstructions. Older homes were not made to assist anyone with physical challenges. Look at how much room is around furniture. Measure how much distance is between the couch and coffee table. Are their cabinets, house plants, or other obstructions between direct paths to and from rooms. A standard walker can range from 23 inches to 26 inches wide. A wheelchair is 32 inches wide. Plus the turning radius needed for a wheelchair is a five foot diameter circle. Are door widths wide enough to accommodate a walker or wheelchair? Can a caregiver safely assist another person in the existing space? Watch to see if your loved one is furniture surfing. Sometimes a person who is having challenges is avoiding the use of a cane or walker. Instead they use their furnishings and counters to support them. The backs of chairs, dressers, tables, countertops, etc. The issue with this is safety. Putting the full body weight of a person on the wrong edge of the furniture can cause the furniture to fall on the person causing injury.
These are just some of the basics, but there are a large number of additional needs for kitchens, bedrooms, bathrooms, closets, laundry rooms, garages, and the always important factor; stairs. Every home is different and every homeowners needs are different. This is where an evaluation by a Certified Aging in Place Specialist is key to making the right changes that are tailored to your situation and budget. Working with the homeowners, family, healthcare professional, and caregivers, we can create a plan so that a home supports current and future needs for everyone involved.
If you or a loved one needs help or is looking to plan for the future and want to consider aging in place needs please feel free to email us at firstname.lastname@example.org to schedule a consultation.